Provider Demographics
NPI:1588001267
Name:RICARDA BENZ MD, INC
Entity Type:Organization
Organization Name:RICARDA BENZ MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BENZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-912-2211
Mailing Address - Street 1:100 E VALENCIA MESA DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3813
Mailing Address - Country:US
Mailing Address - Phone:714-912-2211
Mailing Address - Fax:
Practice Address - Street 1:100 E VALENCIA MESA DR
Practice Address - Street 2:SUITE 215
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3813
Practice Address - Country:US
Practice Address - Phone:714-912-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87188207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty